What is sclerotherapy?
Sclerotherapy literally means scar treatment. In this procedure, a vascular malformation or anomaly may be treated to palliate the symptoms or complications of the vascular malformation. (Use of the word “palliative” is important because sclerotherapy is often performed when a surgical cure is not possible, involves too much risk, or would result in excessive disability for the patient.) Sclerotherapy makes the malformation less significant by reducing the patient’s pain, risk of infection, risk from coagulation disorder or functional limitations. In many cases, sclerotherapy provides a level of relief that makes surgery unnecessary.
Many drugs have been used to perform sclerotherapy procedures. These include strong alcohols, special soaps, proteins, and even some chemotherapy agents. Scar formation is a nonspecific reaction by the body to an irritant or tissue toxin. Not all agents used to perform sclerotherapy are available in the United States. It is important to discuss the appropriate use of these agents with your physician.
When is this procedure performed?
At Columbia, we have a highly developed, multidisciplinary Vascular Malformation Center. Depending on the type of malformation, the distribution of the malformation in the patient’s body, and the organ systems involved, physicians of many different specialties become involved in the care of patients with cutaneous vascular malformations. It is important that patients with vascular malformations receive care at major medical centers with expertise in these disease entities. At such centers, the dedication of physicians and associate staff from many medical and surgical disciplines provide comprehensive care for patients with these conditions.
How is this procedure performed?
Sclerotherapy is an image-guided procedure. Because it is performed without conventional surgery in most cases, physicians with specific skills at image-guided treatments generally perform these procedures. Depending on the type of lesion, a catheter angiogram to evaluate the blood vessels prior to treatment may be important. This test can help to distinguish high-flow from low-flow vascular malformations, which is important because the prognosis and treatments differ. In some cases, particularly for high-flow vascular malformations, treatment may be performed through the blood vessels. The angiogram helps create the treatment plan and can be used as a roadmap for access.
How should I prepare for this procedure?
Before any treatment can be performed, your doctor will need to learn a lot about you. It is important to collect your medical records, even from childhood, for review. Any X-rays or other imaging tests will also be needed for review. The doctor will need copies of your previous evaluations and any lab tests you may have undergone. Even blood test results are important and should be included for review. Bring a list of all your medications, too.
Make sure you understand the goals of the procedure as well as any risks. It may help to write down your questions as you think of them and bring the list to your appointment.
What should I expect after the procedure?
Some patients can go home after their procedures. After the procedure, you will be observed in a recovery room prior to discharge. For more complicated procedures, some patients will remain in the hospital for a day or two for observation or additional treatment, if necessary.
Will I need to take any special medications?
It is unlikely that you will need special medications, but speak with your physician about your particular case.
Will I need rehabilitation or physical therapy?
Rehabilitation, occupational and physical therapy can be very useful as an adjunct to sclerotherapy. These services have much to offer, helping patients to reach their functional goals and maximum potential after treatment.
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